FBN

This thread has now careered off topic with much momentum.

The OP is clearly improving....

The right of a person to choose the way he approaches any event in life is sacrosanct and will be respected on TV. So is freedom of speech unless it infringes on statement no 1..

Thread closed.

Trephination and bloodletting were also common practices, once...

Ganglions are removed mostly for cosmetic reasons as they never are the cause of significant pain or discomfort.

They are, however, associated with degenerative joint disease such as arthritis and this is probably the cause for the pain. Doubtful if simple aspiration of the fluid will relieve the pain.

Perhaps a simple X-ray would help to clear this up..

Proper surgery is the only effective treatment for a ganglion. The ganglion forms when a weakened part of the connective tissue covering the wrist joint gives way and allows the synovial membrane which is the capsule sealing off the joint space to protrude through the weakened area. This "pops up" under the skin as a ganglion but is still connected to the joint and filled with joint fluid.

Removing the liquid will not achieve anything as it will fill up again quite quickly. "Bursting" the ganglion is not appropriate as the joint fluid then leaks into the surrounding tissue.

The proper surgical technique is to isolate the ganglion, find the thin connecting "tube" into the joint and then tie that off. The ganglion capsule must be removed without being broken, ideally..

The 20% failure rate in treatment for giardia is partly or mostly due to drug resistance when treated with Metronidazole so if the infection flares up again a switch of drug is usually advisable.

If there is improvement, no need to change but, if after 4-6 weeks it flares up again, Tinidazole is probably the way to go..

It has less gastrointestinal side effects and is a convenient single dose.

The fatigue is as result of the infection; the parasite destroys intestinal lining leading to mal-absorption; hence also the unpleasant flatulence..

Inguinal hernia is a defect in the connective tissue over the inguinal canal. Surgical repair as soon as it is diagnosed is appropriate as it will prevent a potentially fatal situation if a loop of bowel becomes strangulated.

Surgical repair is the only option and can only be done under spinal block or general anaesthesia. The amount (dose) for a local anaesthetic for this procedure would probably be lethal and the local swelling induced by the volume of fluid injected in the operating field would distort the anatomy so much that the repair would likely fail.

Theoretically, it certainly is possible that activated charcoal may absorb some of the active ingredients of an antibiotic; I could not find any literature to support that though but it would make sense to start taking activated charcoal after the course of antibiotics. It will certainly help with the flatulence.

There is about a 20% failure rate for treatment with metronidazole but re-infection via fecal/oral route is common.

The dose for Flagyl (metronidazole) is 250mg three times daily for at least 7 days.

Alternate treatment is Tinidazole as a single oral dose of 2g which, in the OP's case is advisable.

This topic was ill-defined at best and this thread has now gone way off topic.

It is now closed.

There are no lymph nodes "between chest pecs" ; assuming you mean between the pectoral muscles on the chest, on the breast bone. This must be some swelling due to a different reason.

You have tested negative for HIV; the sensible thing to do would be to have another test in three month's time as you clearly still have much anxiety over this.

Consider counselling, not just for HIV but for your general anxiety about this whole unfortunate episode.

Several posts have been removed from this thread. They were considered to be inflammatory and of a personal nature.

This is a Health Forum, not one for personal conversations of the type taken out of the thread.

Keep the topic on the medical aspects of the case; personal conversations of this type do not add value and should be done offline.

Duration of antibiotic treatment depends on the condition being treated; usually a course of 7-10 days is adequate for acute infections. I some cases, such as yours where there has been an open fracture, longer duration may be needed. However, 24 days seems a bit excessive now but the decision to stop rests exclusively with the treating doctor.

Be sure to also include food items in your diet such as natural yoghurt and fresh fruit etc to help re-establishing the normal bacteria in the intestine.

Tests that can be done to indicate an ongoing infection include a white cell count and a very old but fairly reliable test such as a simple ESR or erythrocyte sedimentation rate may be useful.

ESR is simply a blood sample in a special glass tube stood upright and the rate of separation of serum and red blood cells is measured; the quicker the separation, the higher the chance of ongoing infection.

I did treat gonorrhea with 2 injections

But i did read the hiv in thailand is morre transable to hetrosexual

And i have done hiv 1 nat test after 16 days of exposure

But the question is, does nat test detects the hiv subtype in thailand ?

I mean do they use nat in thailand too??

HIV subtype in Thailand is not "more transmissable"; the more accurate statement is that HIV transmission in Thailand is more hetero- than homosexual which is different in the US and other countries.

Your opening post states the you were "negative" for HIV; the NAT test at this time period is very accurate and conclusive. Subtype does not matter or affect the test outcome.

NAT test is available from the Thai Red Cross hospital in Bangkok but you seem to have had the test outside of Thailand so this is not really relevant.

You need to discuss this with a STD specialist not the "laboratory doctor".

You don't say which country you are in so presumably not Thailand any more.

First of all you need to see a physician familiar with STD/HIV; a detailed history and discussion will relieve your anxiety much more than a forum discussion can ever achieve. It is also essential to ensure that the gonorrhoea is adequately treated.

You seem to have had protected sex which should provide relatively good protection against gonorrhoea as well as HIV but your details are unclear. Male contact with an HIV positive female with single exposure does not automatically result in infection; male infected persons have a much higher rate of transmission than female due to the volume of secretions shared.

NAT test as well as the p24 test is reliable in your exposure period; subtype is of little relevance right now.

Joint pains are a relatively common side effect of this group of antibiotics; could cause growth abnormalities if taken by growing children.

Magnesium on its own will probably not be sufficient; hydration with a balanced electrolyte solution will be better.

Feeling better in hospital with elevated CPK is probably more related to adequate hydration while on IV fluids. It is critical after such an episode to maintain very high levels of hydration through water and electrolyte intake. MRI will probably not show anything as this is associated with non-specific muscle breakdown during the extreme exercise.

Difficult to estimate how quickly this will be over but one week may be a bit optimistic. It will probably gradually get better over the next few weeks.

Follow up tests for liver and kidney functions, including just a dipstick test for proteins in the urine is appropriate.

Have some blood taken for uric acid levels. Looks like a typical gout inflammatory reaction.. Definitely not a tumour.

Pain in the upper back is usually due to stress or strain on the Rhomboid muscles; google "rhomboids" ; lots of useful info there..

Good to remember that the upper limb is "suspended" from the body; anchored by muscles and ligaments unlike the lower limbs which have a solid "ball and socket" weight bearing joint. This makes the upper back and the anchoring muscles much more prone to repetitive movement strain..

Possibly a pillow that is too firm but, if you do any computer work, a thorough evaluation of your workstation should also be done. Arms not supported on arm rests in line or at the same level as the keyboard can also cause this.

Massage in the hands of a good therapist on a regular basis also helps.

The usual cause for return of fungal infections are inadequate treatment; topical treatment with antifungal creams should continue for at least 4-6 weeks even if it seems cleared.

Once an allergic reaction to elements in the air sets in, it is difficult to stop without a short course of antihistamines or a nasal spray that contains a steroid. The inflammatory reaction, once set off by an irritant, gets established almost anything could trigger sneezing etc.

It is amazing how much particles are caught by an air conditioner. Here in central BKK, AC service and filter cleaning is essential at least every 4-6 months so a single therapy such as antihistamine is usually not enough and must be combined with general measures such as AC cleaning, damp dusting in homes and also ensure that vacuum cleaners are fitted with proper HEPA filters.

I read somewhere, but can't recall so verify this information before you believe it....

Proviron (spelling) a medication for people with too low Testosterone was said to increase Sperm count and quality.

(But again I am not sure if I recall it right)

Proviron/Provironum is available and has been used for this purpose but keep in mind it is a testosterone product and should be taken with care and not without prior workup by a urologist in older males as it may increase the possibility of prostate carcinoma.

Cut out smoking, reduce alcohol etc if you do both..

Age? Any existing children?

IVF may be an option but low success rate if the sperm mobility is so low..

Anti inflammatories like Indomethacin (Indocid) or Ibuprofen seems to work better in acute gout than any other; especially the Indocid suppository. May be worth a try but support the notion to get a blood test for both uric acid levels as well as kidney functions.

In the mean time be sure to take in lots of fluids.

Presence of antibodies from a prior infection do increase the risk of Hemorrhagic fever but more common in children than adults. Even then it is not that common.

The mechanism of the bleeding is an auto-immune reaction against the infected person's own platelets causing them to drop below levels where bleeding ensues; usually at levels around 20 000.

It would be very important to use insect repellants, where light clothing and cover up.

If you do get fever, keep monitoring. Early signs are a rash with the fever. Best to use paracetamol for the fever and not drugs like aspirin or ibuprofen. The blood test becomes positive around day 4-6 after onset of fever and platelets start dropping at more or less the same time; once this happens, it is important to get a platelet and blood count done on a daily basis.

Steep drops will lead to hospital admission when levels drop to 60 000 or so. Treatment can be platelet transfusions but otherwise supportive.

Kids are more prone to develop the Dengue shock syndrome.

Check out "Bumrungrad Residence" it is annexed to the hospital and operates similar to hotel/serviced apartment.